Annals of Thoracic and Cardiovascular Surgery
Online ISSN : 2186-1005
Print ISSN : 1341-1098
ISSN-L : 1341-1098
Unilateral Lower Extremity Edema and Lymphorrhea as Manifestations of a Ruptured Iliac Artery Aneurysm and Arteriovenous Fistula
Shinsuke NishimuraTakashi MurakamiHiromichi FujiiYosuke TakahashiAkimasa MorisakiToshihiko Shibata
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JOURNALS OPEN ACCESS Advance online publication

Article ID: cr.17-00245


An arteriovenous fistula is a rare complication of ruptured abdominal aortic or iliac artery aneurysms (IAAs). Its clinical symptoms depend on its size, with signs of heart failure dominating if the fistula is large. Herein, we present a case of arteriovenous fistula with an unusual presentation. An 86-year-old male patient presented with extreme lower extremity edema, skin erosion, and continuous lymphorrhea (starting 3 months prior). Despite the large fistula between the right common IAA and the left common iliac vein after the rupture of the aneurysm, he did not develop heart failure symptoms, as the large shunt was predominantly directed toward the left lower extremity due to iliac vein compression. Careful physical examination and a high index of suspicion could have contributed to an earlier diagnosis and management.

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